Vasovagal Reflex and Orthostatic Intolerance

What’s happening in my body?

Your brain is always trying to keep you safe, even when you stand up too fast or walk down the hall in the morning. Sometimes, your body’s reflexes get overwhelmed. That’s where orthostatic intolerance and the vagus nerve come in.

The morning challenge

• You’ve been lying in bed. Your blood pressure is calm and normal.
• You stand up and walk down the hall. Gravity pulls blood toward your feet.
• Your brain panics: “Wait. I need that blood!”
• It gives you an adrenaline rush to raise your blood pressure and heart rate.

Enter the vagus nerve

• The vagus nerve is a big nerve that runs from your brainstem to your heart, stomach, and more.
• This is the “rest and digest” nerve. It’s in charge of things like digestion, sweating, throwing up – everything that’s not “run from a bear” mode.
• When your heart starts to feel empty because not enough blood is filling it, the vagus nerve fires to slow down your heart so each beat can carry more blood. 

But sometimes, it backfires

• Now you have a low heart rate and low blood pressure.
• Your brain still isn’t getting enough blood, so it starts to react.
  • You feel lightheaded.
  • You may experience tunnel vision, ringing in your ears, or nausea.
  • That’s your brain saying, “SIT DOWN. I need help!”

Why fainting can actually make you feel better

• When you faint, the blood comes back to your brain.
• The vagus nerve stops overreacting, and your body resets.
• People who faint often feel better than people who almost faint. 

The overloaded phone analogy

Think of your vagus nerve like your phone when it has too
many apps open.

• It’s trying to keep up, doing so many jobs at once.
• Then it freezes or glitches – you feel dizzy, foggy, nauseated.
• If you yell at your phone or keep pushing it harder, it won’t help.
• But if you pause, close some apps, plug it in, and restart gently, it works better. 

Your body is the same way.

• You need to listen, slow down, and care for your system.
• Be compassionate, curious, and kind to your overloaded nerve.
• The goal isn’t to fight the vagus nerve, but to support it. 

What helps?

• Hydration and salt help blood volume.
• Avoiding triggers like caffeine and energy drinks.
• Compression stockings can help the blood return to your heart.
• Exercise, both aerobic and strength training.
• Good restful sleep.
• Cognitive behavioral therapy (counseling).